GENETIC MARKERS IN GYNECOLOGIC ONCOLOGY: UNDERSTANDING HEREDITARY RISKS AND MUTATIONS

Main Article Content

Dr Bibekananda Das
Dr Kajal Kumar Patra

Keywords

hereditary cancer, gynecologic oncology, BRCA mutations, mismatch repair deficiency, genetic risk, primary data, molecular markers

Abstract

The research question of the study is the patterns of the risk of hereditary cancer and the awareness of genetic markers in women undergoing gynecologic evaluation. A questionnaire with a structured questionnaire was used to gather primary data by the administration of a questionnaire to ninety respondents to evaluate their knowledge of BRCA and mismatch repair mutation, previous genetic testing, and perceived cancer risk. The findings showed that the percentage of the participants who reported a family history of breast, ovarian, endometrial or colorectal cancer was quite high, which implied that the participants had a hereditary predisposition. The awareness of BRCA mutations exceeded that of mismatch repair defects, but clinically performed pathogenic mutations were detected in only a small proportion of the respondents. There was different risk perception where most of the participants perceived themselves to be moderate risk. These results indicate that awareness of hereditary cancer is growing but there are still gaps in the knowledge on the genetic pathways and genetic testing. The improvement of prevention and individualized therapy in gynecologic oncology is necessary through the strengthening of genetic counseling, the development of diagnostic services, and the promotion of early assessment of hereditary risks.

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References

1. Andrews, L., & Mutch, D. G. (2017). Hereditary ovarian cancer and risk reduction. Best practice & research Clinical obstetrics & gynaecology, 41, 31-48.
2. Carvalho, F. M., & Carvalho, J. P. (2024). Unraveling the Heterogeneity of Deficiency of Mismatch Repair Proteins in Endometrial Cancer: Predictive Biomarkers and Assessment Challenges. Cancers, 16(20), 3452.
3. Chung, S. H., Woldenberg, N., Roth, A. R., Masamed, R., Conlon, W., Cohen, J. G., ... & Patel, M. K. (2020). BRCA and beyond: comprehensive image-rich review of hereditary breast and gynecologic cancer syndromes. Radiographics, 40(2), 306-325.
4. Concin, N., Matias-Guiu, X., Vergote, I., Cibula, D., Mirza, M. R., Marnitz, S., ... & Creutzberg, C. L. (2021). ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. International Journal of Gynecological Cancer, 31(1), 12-39.
5. Daly, M. B., Pilarski, R., Yurgelun, M. B., Berry, M. P., Buys, S. S., Dickson, P., ... & Darlow, S. D. (2020). NCCN guidelines insights: genetic/familial high-risk assessment: breast, ovarian, and pancreatic, version 1.2020: featured updates to the NCCN guidelines. Journal of the National Comprehensive Cancer Network, 18(4), 380-391.
6. Gaffney, D., Matias-Guiu, X., Mutch, D., Scambia, G., Creutzberg, C., Fotopoulou, C., ... & Concin, N. (2024). 2023 FIGO staging system for endometrial cancer: The evolution of the revolution. Gynecologic oncology, 184, 245-253.
7. Hoang, L. N., & Gilks, B. C. (2018). Hereditary breast and ovarian cancer syndrome: moving beyond BRCA1 and BRCA2. Advances in anatomic pathology, 25(2), 85-95.
8. Jamieson, A., Bosse, T., & McAlpine, J. N. (2021). The emerging role of molecular pathology in directing the systemic treatment of endometrial cancer. Therapeutic advances in medical oncology, 13, 17588359211035959.
9. Kondrashova, O., Shamsani, J., O’Mara, T. A., Newell, F., Reed, A. E. M., Lakhani, S. R., ... & Spurdle, A. B. (2021). Tumor signature analysis implicates hereditary cancer genes in endometrial cancer development. Cancers, 13(8), 1762.
10. Konstantinopoulos, P. A., Norquist, B., Lacchetti, C., Armstrong, D., Grisham, R. N., Goodfellow, P. J., ... & Annunziata, C. M. (2020). Germline and somatic tumor testing in epithelial ovarian cancer: ASCO guideline. Journal of clinical oncology, 38(11), 1222-1245.
11. Kostov, S., Watrowski, R., Kornovski, Y., Dzhenkov, D., Slavchev, S., Ivanova, Y., & Yordanov, A. (2022). Hereditary gynecologic cancer syndromes–a narrative review. OncoTargets and therapy, 381-405.
12. León-Castillo, A., De Boer, S. M., Powell, M. E., Mileshkin, L. R., Mackay, H. J., Leary, A., ... & TransPORTEC Consortium. (2020). Molecular classification of the PORTEC-3 trial for high-risk endometrial cancer: impact on prognosis and benefit from adjuvant therapy. Journal of Clinical Oncology, 38(29), 3388-3397.
13. Lheureux, S., Braunstein, M., & Oza, A. M. (2019). Epithelial ovarian cancer: evolution of management in the era of precision medicine. CA: a cancer journal for clinicians, 69(4), 280-304.
14. Loukovaara, M., Pasanen, A., & Bützow, R. (2022). Molecular classification of endometrial carcinoma: a clinically oriented review. Journal of Clinical Pathology, 75(11), 731-738.
15. Lu, K. H., & Broaddus, R. R. (2020). Endometrial cancer. New England Journal of Medicine, 383(21), 2053-2064.
16. Nagel, J., Paschoalini, R. B., Barreto, P. S. D., Credidio, C. H., Paulino, E., & Del Pilar Estevez-Diz, M. (2024). Predictive biomarkers in endometrial carcinomas: a review of their relevance in daily anatomic pathology. Surgical and Experimental Pathology, 7(1), 21.
17. Porter, V. L., & Marra, M. A. (2022). The drivers, mechanisms, and consequences of genome instability in HPV-driven cancers. Cancers, 14(19), 4623.
18. Purohit, P. K., Shah, A. S., Chavda, G. H., Thakkar, D. A., Patel, M. G., Zaveri, K. D., & Chokshi, S. K. (2024). Genetic Predisposition to Gynecological Cancers: Understanding the Role of Genetic Variants and Familial Risk. Frontiers in Health Informatics, 13(3).
19. Ray-Coquard, I., Pautier, P., Pignata, S., Pérol, D., González-Martín, A., Berger, R., ... & Harter, P. (2019). Olaparib plus bevacizumab as first-line maintenance in ovarian cancer. New England Journal of Medicine, 381(25), 2416-2428.
20. Watanabe, T., Soeda, S., Okoshi, C., Fukuda, T., Yasuda, S., & Fujimori, K. (2023). Landscape of somatic mutated genes and inherited susceptibility genes in gynecological cancer. Journal of Obstetrics and Gynaecology Research, 49(11), 2629-2643.
21. Yao, Q., Liu, Y., Zhang, L., Dong, L., Bao, L., Bai, Q., ... & Zhou, X. (2022). Mutation landscape of homologous recombination repair genes in epithelial ovarian cancer in china and its relationship with clinicopathlological characteristics. Frontiers in Oncology, 12, 709645.
22. Zhao, M., Teng, X. M., Yan, Q., & Hao, F. (2025). Risk Assessment and Fertility Counseling for Hereditary Gynecological Cancer Syndromes. Cancer Medicine, 14(17), e71206.